ABSTRACT
Objective To evaluate the therapeutic effects and safety of transcatheter arterial sclerosing embolization (TASE) combined with oral Propranolol in infantile huge hemangiomas.Methods A total of 76 infants with huge hemangioma were treated by TASE.All patients received oral Propranolol based on their weight.The follow-up and efficacy evaluation were performed from the last treatment.And the complications were analyzed.Results Seventy-six cases underwent 95 case-times of TASE totally.The success rate of puncture technique was 100％ (95/95).All patients were divided into 5 levels (0-Ⅳ levels) based on the curative effect of the follow-up,including 6 cases (6/76,7.90％) of level Ⅰ,19 cases (19/76,25.00％) of level Ⅱ,23 cases (23/76,30.26％) of level l,and 28 cases (28/76,36.84％) of level Ⅳ.The total effective rate was 100％ (76/76).There was no serious complications,and the curative effect was stable during the follow-up.Conclusion TASE combined with oral Propranolol in infantile huge hemangiomas is effective with less invasiveness and fewer complications.
ABSTRACT
Objective To investigate the efficacy and safety of transcather arterial embolization (TAE) plus sirolimus for the treatment of refractory Kasabach-Merritt syndrome (KMS) in infants. Methods Clinical data of twelve infants with refractory KMS treated between December 2015 and October 2016 in a single hospital were retrospectively analyzed. TAE were performed in all patients after failed traditional multiple therapies, followed by oral sirolimus administration. The dose of sirolimus was modulated according to the level of sirolimus, the count of platelet, the shrinkage of the lesion and the side effects, which were monitored regularly during the study. Results All 12 patients were treated with TAE plus sirolimus therapies successfully. The platelet count for all patients increased to≥100×109/L for the first time at (7±5) days. Stabilization of platelet level was obtained in (15±7) days averagely. Before the treatment, two infants had a normal fibrinogen level and the fibrinogen level in the other 10 infants was found to be increased to≥2.0 g/L at (9 ± 4)days for the first time and was then stabilized at levels>2.0 g/L at (19 ± 7)days after treatment. One patient showed skin fester (GradeⅡ), one patient had a fever with acute pulmonary infection (Grade Ⅲ) and both patients improved well after symptomatic treatment. There were no serious complications in the other ten patients. Conclusions TAE plus sirolimus can rapidly improve levels of platelets and fibrinogen, and it is a safe, useful and effective method for treatment of refractory KMS in infants.
ABSTRACT
Objective To evaluate the therapeutic effects and safety of transcatheter arterial sclerosing embolization (TASE) combined with oral Propranolol in infantile huge hemangiomas.Methods A total of 76 infants with huge hemangioma were treated by TASE.All patients received oral Propranolol based on their weight.The follow-up and efficacy evaluation were performed from the last treatment.And the complications were analyzed.Results Seventy-six cases underwent 95 case-times of TASE totally.The success rate of puncture technique was 100％ (95/95).All patients were divided into 5 levels (0-Ⅳ levels) based on the curative effect of the follow-up,including 6 cases (6/76,7.90％) of level Ⅰ,19 cases (19/76,25.00％) of level Ⅱ,23 cases (23/76,30.26％) of level l,and 28 cases (28/76,36.84％) of level Ⅳ.The total effective rate was 100％ (76/76).There was no serious complications,and the curative effect was stable during the follow-up.Conclusion TASE combined with oral Propranolol in infantile huge hemangiomas is effective with less invasiveness and fewer complications.
ABSTRACT
Objective To analyze the efficacy and safety of Intra-arterial chemotherapy (IAC) as secondly treatment in children with retinoblastoma (RB).Methods 42 eyes of 34 consecutive RB patients were enrolled in the study after intravenous chemotherapy (IVC),including 26 males and 8 females.The average age is 14.1 months.21 cases were bilateral and 7 cases were unilateral.A total of 42 eyes of 34 patients were classified according to the International Intraocular Retinoblastoma Classification (IIRC) as group B(n=1,2.4％),group C (n=3,7.1％),group D (n=32,76.2％),or group E (n=6,14.3％).Tumor recurrence and tumor enlargement after IVC were 4 and 10 eyes respectively,accounting for 9.0％ and 24.0％ respectively.Sequential treatment after IVC followed by IAC were 28 eyes,accounting for 67.0％.All treatment eyes received IAC combined with laser,cryotherapy and other eye local treatment.The IAC regimen adopted the combination and alternation administration mode,by the combination of melphalan and carboplatin or the combination of melphalan and topotecan.According to the tumor changes after IAC decide whether IAC again.If tumors increased,vitreous or subretinal implants increased will be termination of IAC and enucleation.The mean follow-up time was (21.4±3.7) months after the last IAC treatment and (6.2±2.9) months after enucleation.Ocular preservation rate and complication were evaluated.Results The average IAC procedures performed on 42 eyes were (4.0±0.9).An overall ocular preservation rate of 76.2％ was observed during follow-up periods due to calcification or inactivation of tumors (32 eyes),including group B (n=1,100％),group C (n=1,33.3％),group D (n=27,84.4％),group E (n=3,50％).10 eyes were enucleated.Among them,2 eyes of the tumor did not shrink after IAC,tumor recurrence (n=3),vitreous hemorrhage (n=3),enophthalmos (n=1),vitreous disseminated (n=1).34 cases of children,transient eyelid oedema were 18 cases,vitreous hemorrhage and bone marrow suppression (Ⅰ-Ⅳ) were 1,22 casese respectively.Conclusions IAC as secondly treatment is safe and effective for RB patients,however,there is still tumor recurrence.No serious ocular local and systemic complications were observed.
ABSTRACT
Objective To investigate the efficacy and safety of transcather arterial embolization (TAE) plus sirolimus for the treatment of refractory Kasabach-Merritt syndrome (KMS) in infants. Methods Clinical data of twelve infants with refractory KMS treated between December 2015 and October 2016 in a single hospital were retrospectively analyzed. TAE were performed in all patients after failed traditional multiple therapies, followed by oral sirolimus administration. The dose of sirolimus was modulated according to the level of sirolimus, the count of platelet, the shrinkage of the lesion and the side effects, which were monitored regularly during the study. Results All 12 patients were treated with TAE plus sirolimus therapies successfully. The platelet count for all patients increased to≥100×109/L for the first time at (7±5) days. Stabilization of platelet level was obtained in (15±7) days averagely. Before the treatment, two infants had a normal fibrinogen level and the fibrinogen level in the other 10 infants was found to be increased to≥2.0 g/L at (9 ± 4)days for the first time and was then stabilized at levels>2.0 g/L at (19 ± 7)days after treatment. One patient showed skin fester (GradeⅡ), one patient had a fever with acute pulmonary infection (Grade Ⅲ) and both patients improved well after symptomatic treatment. There were no serious complications in the other ten patients. Conclusions TAE plus sirolimus can rapidly improve levels of platelets and fibrinogen, and it is a safe, useful and effective method for treatment of refractory KMS in infants.